Reflexos da qualidade da APS sobre a incidência de Covid-19 nas microrregiões de saúde de Minas Gerais: um olhar a partir da perspectiva dos usuários

Abstract

Introduction: with the creation of the Unified Health System in 1988, municipalities began to absorb a wider range of attributions and responsibilities in health, organizing it in a regionalized for better hierarchical integration of services, with the purpose of constituting health care networks (RAS). In the health care networks, Primary Health Care occupies the role of network organizer and care coordinator by meeting the growing health needs of the population, even more evident in the context of the COVID-19 pandemic. Objective: to evaluate the effects of Primary Health Care quality from the perspective of users on the incidence of COVID-19 in the health micro-regions of Minas Gerais Method: quantitative, cross-sectional and ecological study, carried out based on the results referring to the assessment of the quality of Primary Health Care by the PMAQ-AB, cycle III - user satisfaction module (2018), correlating to the epidemiological indicator, incidence rate for COVID-19 and context variables. The study scenario is the state of Minas Gerais and the unit of analysis the 89 health micro-regions of the state. Descriptive analyzes by mean values and standard deviation were performed for the study variables. Subsequently, the global spatial correlation was evaluated using the Moran index and the presence of clusters using the local indicator of spatial autocorrelation: ”LISA”. Lagrange multiplier tests were applied, which demonstrated that the spatial autoregressive model (SAR) was the most suitable for the analysis (lowest p-value). Result: Among the 9 selected APS quality dimensions, there was a negative association between home visits and the incidence rate of COVID-19 (beta: -1.15 and p-value: 0.03) and a positive association with the quality of consultations and link of basic health unit in the incidence rate of COVID-19 (beta: 2.79 and pvalue: 0.03). No association was found between the PMAQ-AB incentive and the incidence rates of COVID-19. Final Considerations: the results point to the importance of deepening the discussion in relation to the primary care financing model and the appreciation of territorialization with customer subscription and family and community orientation , also demonstrating the effect of the bond and reception of users with the Basic Health Unit guided by the Family Health Strategy in the context of the COVID-19 pandemic.